Pancreatogastrostomy as a Salvage Procedure to Treat Severe Postoperative Pancreatic Fistula After Pancreatoduodenectomy

Bachellier, Philippe; Oussoultzoglou, Elíe; Rosso, Edoardo; Scurtu, Radu Razvan; Lucescu, Ioan; Oshita, Akihiko; Jaeck, Daniel

doi:10.1001/archsurg.143.10.966

Cited by 49 publications

(36 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Two of them required additional operative pancreatic debridement and drainage procedures. These patients had long and complicated hospital courses, and 1 died after progressing to multiorgan failure.’ Bachellier et al [9] reported that they performed revision pancreaticogastrostomy during the secondary operation for patients with severe pancreatic fistula to substitute the original pancreaticogastrostomy (4 cases), and the results were satisfactory; however, 4 of 8 patients who underwent pancreatectomy died after the operation.…”

Section: Discussionmentioning

confidence: 99%

A Novel Technique for the Management of Pancreaticojejunal Anastomosis Dehiscence following Pancreaticoduodenectomy

Dai³

2010

Dig Surg

View full text Add to dashboard Cite

Background: To report a novel technique for management of pancreaticojejunal anastomosis dehiscence after pancreaticoduodenectomy. Material and Methods: The anastomosis is disconnected and the blind jejunal limb is shortened and closed. A silicon tube in the pancreatic duct introduced in the first operation is fixed at the pancreatic stump. If no tube was placed during pancreaticoduodenectomy, it is placed at reoperation. The transected edge of the pancreas is stitched, and the distal part of the silicon tube is inserted into the jejunal loop and fixed in the jejunal wall. Drains and a catheter for continuous irrigation are placed. Results: All patients tolerated reoperation and experienced unremarkable postoperative courses. Follow-up ranged from 5 to 27 months, and all patients exhibited normal pancreatic function and no pseudocyst formation. Conclusion: This technique is an effective method for management of pancreaticojejunal anastomosis dehiscence that avoids complications associated with completion pancreatectomy and preserves pancreatic function.

show abstract

Section: Discussionmentioning

confidence: 99%

A Novel Technique for the Management of Pancreaticojejunal Anastomosis Dehiscence following Pancreaticoduodenectomy

Dai³

2010

Dig Surg

View full text Add to dashboard Cite

show abstract

“…Nevertheless, surgery is imperative for patients with marked clinical worsening, inefficient percutaneous drainage of abscesses, vascular complications, progressive sepsis, oncoming organ failure, etc. These situations are commonly associated with elevated postoperative mortality (29).…”

Section: Pancreatic Fistula (Pf)mentioning

confidence: 99%

Management of postoperative complications of lymphadenectomy

Barchi¹,

Charruf²,

Oliveira³

et al. 2016

Transl. Gastroenterol. Hepatol.

View full text Add to dashboard Cite

Gastric cancer remains a disease with poor prognosis, mainly due to its late diagnosis. Surgery remains as the only treatment with curative intent, where the goal is radical resection with free-margin gastrectomy and extended lymphadenectomy. Over the last two decades there has been an improvement on postoperative outcomes. However, complications rate is still not negligible even in high volume specialized centers and are directly related mainly to the type of gastric resection: total or subtotal, combined with adjacent organs resection and the extension of lymphadenectomy (D1, D2 and D3). The aim of this study is to analyze the complications specific-related to lymphadenectomy in gastric cancer surgery.

show abstract

“…Mortality was 0 % after salvage pancreaticogastrostomy and 50 % after completion pancreatectomy. Despite retrospective and affected by selection bias, this data indicated that salvage pancreaticogastrostomy is a safe and efficient alternative to completion pancreatectomy for the treatment of grade C POPF after PD with pancreaticojejunostomy [50].…”

Section: Surgical Treatmentmentioning

confidence: 87%

Diagnosis and management of postoperative pancreatic fistula

Malleo

Pulvirenti

Marchegiani

et al. 2014

Langenbecks Arch Surg

View full text Add to dashboard Cite

The high incidence of POPF was accompanied by a shift from operative to non-operative management. However, the current management strategy is driven by the patient's condition and local expertise and is generally based on poor evidence. A randomized trial showed that enteral nutrition is superior to total parenteral nutrition, and pooled data of randomized trials failed to show any advantage of somatostatin analogs for accelerating fistula closure. The choice of percutaneous versus endoscopic drainage of peripancreatic collections remains arbitrary, and-when re-operation is needed-there are very few comparative data regarding local drainage with or without main pancreatic stenting as opposed to anastomotic revision or salvage re-anastomosis. The continuous development of specialist, high-volume units with appropriate resources and multidisciplinary experience in complication management might further improve the evidence and the outcomes.

show abstract

Pancreatogastrostomy as a Salvage Procedure to Treat Severe Postoperative Pancreatic Fistula After Pancreatoduodenectomy

Cited by 49 publications

References 27 publications

A Novel Technique for the Management of Pancreaticojejunal Anastomosis Dehiscence following Pancreaticoduodenectomy

A Novel Technique for the Management of Pancreaticojejunal Anastomosis Dehiscence following Pancreaticoduodenectomy

Management of postoperative complications of lymphadenectomy

Diagnosis and management of postoperative pancreatic fistula

Contact Info

Product

Resources

About